Abstract
A lack of representation of skin of color (SoC) in dermatology curricula is well-documented across North American medical schools and may present a barrier to equitable and comprehensive undergraduate medical education. This study aims to examine representation in dermatologic educational materials and appreciate a link between bias in dermatologic education and student diagnostic ability and self-rated confidence. The University of Toronto Dermatology Undergraduate Medical Education curriculum was examined for the percentage photographic representation of SoC. A survey of 10 multiple-choice questions was administered to first- and third-year medical students at the University of Toronto to assess diagnostic accuracy and self-rated confidence in diagnosis of 5 common skin lesions in Fitzpatrick skin phototypes (SPT) I-III (white skin) and VI-VI (SoC). The curriculum audit showed that <7% of all images of skin disease were in SoC. Diagnostic accuracy was fair for both first- (77.8% and 85.9%) and third-year (71.3% and 72.4%) cohorts in white skin and SoC, respectively. Students' overall self-rated confidence was significantly greater in white skin when compared to SoC, in both first- (18.75/25 and 17.78/25, respectively) and third-year students (17.75/25 and 15.79/25, respectively) (P = .0002). This preliminary assessment identified a lack of confidence in diagnosing dermatologic conditions in SoC, a finding which may impact health outcomes of patients with SoC. This project is an important first step in diversifying curricular materials to provide comprehensive medical education.
Highlights
A lack of diversity in dermatology education is a well- documented concern.[1,2] Upon review of dermatology practice in Canada, there are gaps in knowledge of the management of common skin conditions in skin of color (SoC).[2]
The curriculum audit revealed that of 513 images represented in dermatology teaching materials, 19 (3.7%) displayed conditions in SoC
This finding is lower than rates seen in medical curricula at other North American medical schools.[11,12,13]
Summary
A lack of diversity in dermatology education is a well- documented concern.[1,2] Upon review of dermatology practice in Canada, there are gaps in knowledge of the management of common skin conditions in SoC.[2]. The Fitzpatrick skin phototype (SPT) scale is used to describe skin types based on their reactivity to ultraviolet radiation According to this system, “SoC” includes SPT IV through VI, skin that tans readily and rarely burns on sun exposure. A survey of 10 multiple-choice questions was administered to firstand third-year medical students at the University of Toronto to assess diagnostic accuracy and self-rated confidence in diagnosis of 5 common skin lesions in Fitzpatrick skin phototypes (SPT) I-III (white skin) and VI-VI (SoC). Conclusions: This preliminary assessment identified a lack of confidence in diagnosing dermatologic conditions in SoC, a finding which may impact health outcomes of patients with SoC. This project is an important first step in diversifying curricular materials to provide comprehensive medical education
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